PKG00255048-instructions.pdf

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Bureau of Primary Health Care Office of Policy and Program Development

National Health Center Training and Technical Assistance Partners

Cooperative Agreements (NTTAP)

Funding Opportunity Number: HRSA-20-022 Funding Opportunity Type(s): Competing Continuation, New

Assistance Listings (CFDA) Number: 93.129

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2020

Application Due Date in Grants.gov: November 15, 2019 Supplemental Information Due Date in HRSA EHBs:

December 17, 2019

Ensure your SAM and Grants.gov registrations and passwords are current immediately!

HRSA will not approve deadline extensions for lack of registration.

Registration in all systems, including SAM.gov, Grants.gov and EHBs, may take up to 1 month to complete.

Issuance Date: September 16, 2019

Kathleen Shannon Public Health Analyst, Office of Policy and Program Development, Bureau of Primary Health Care Contact: https://www.hrsa.gov/about/contact/bphc.aspx Telephone: (301) 594-4300 NTTAP Technical Assistance Webpage:

https://bphc.hrsa.gov/program-opportunities/funding-opportunities/nttap

Authority: Public Health Service Act, as amended, Title III, Section 330(l) (42 U.S.C. 254b(l)) https://www.hrsa.gov/about/contact/bphc.aspx https://bphc.hrsa.gov/program-opportunities/funding-opportunities/nttap

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EXECUTIVE SUMMARY

The Health Resources and Services Administration (HRSA) is accepting applications for the fiscal year (FY) 2020 National Health Center Training and Technical Assistance Partners (NTTAP) Cooperative Agreements.1 This funding will establish or maintain cooperative agreements with organizations to provide national-level training and technical assistance (T/TA) to existing and potential health centers to increase access to high quality, comprehensive primary care services for underserved populations in an evolving health care landscape. Existing health centers include Health Center Program award recipients and look-alikes. Potential health centers include organizations that are applying for or seeking information about applying for a Health Center Program award or look-alike designation. NTTAPs provide health center T/TA directly and through collaborations with HRSA-funded and other T/TA partners.

Funding Opportunity Title:

National Health Center Training and Technical Assistance Partners (NTTAP) Cooperative Agreements

Funding Opportunity Number: HRSA-20-022

Due Date for Applications in Grants.gov: November 15, 2019 (11:59 pm ET)

Due Date for Supplemental Information in HRSA Electronic Handbooks (EHBs): December 17, 2019 (5:00 pm ET)

Anticipated Total Annual Available FY 2020 Funding: $22 million

Estimated Number and Type of Awards: Up to 21 cooperative agreements

Estimated Award Amount: Varies

Cost Sharing/Match Required: No

Period of Performance: July 1, 2020 through June 30, 2023

Eligible Applicants:

Eligible applicants include domestic public, non-profit, and for-profit entities, including tribal and faith-based organizations. New organizations and organizations currently receiving funding as NCAs may submit applications.

See Section III of this notice of funding opportunity (NOFO) for complete eligibility information.

1 NTTAP Cooperative Agreements were previously referred to as National Training and Technical Assistance Cooperative Agreements or NCAs.

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Application Guide

You (the applicant organization/agency) are responsible for reading and complying with the instructions included in HRSA’s SF-424 Two-Tier Application Guide, available online at http://www.hrsa.gov/grants/apply/applicationguide/sf424programspecificappguide.pdf.

Technical Assistance

Application resources, frequently asked questions (FAQs), and sample forms and documents are available at the NTTAP Technical Assistance webpage (https://bphc.hrsa.gov/program-opportunities/funding-opportunities/nttap).

HRSA will hold a pre-application technical assistance (TA) call for applicants seeking funding through this opportunity. This TA session will provide an overview of this NOFO and an opportunity for applicants to ask questions. Visit the webpage above for TA webinar details (date, time, dial-in number, web link).

http://www.hrsa.gov/grants/apply/applicationguide/sf424programspecificappguide.pdf

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Table of Contents

I. FUNDING OPPORTUNITY DESCRIPTION

1. PURPOSE

2. BACKGROUND

II. AWARD INFORMATION

1. TYPE OF APPLICATION AND AWARD

2. SUMMARY OF FUNDING

III. ELIGIBILITY INFORMATION

1. ELIGIBLE APPLICANTS

2. COST SHARING/MATCHING

3. OTHER

IV. APPLICATION AND SUBMISSION INFORMATION

1. ADDRESS TO REQUEST APPLICATION PACKAGE

2. CONTENT AND FORM OF APPLICATION SUBMISSION

i. Project Abstract

ii. Project Narrative

iii. Budget

iv. Budget Narrative (submitted in EHBs)

v. Program-Specific Forms (Submit in HRSA EHBs)

vi. Attachments

3. DUN AND BRADSTREET DATA UNIVERSAL NUMBERING SYSTEM (DUNS) NUMBER SYSTEM

FOR AWARD MANAGEMENT AND GRANTS.GOV

4. SUBMISSION DATES AND TIMES

5. INTERGOVERNMENTAL REVIEW

6. FUNDING RESTRICTIONS

V. APPLICATION REVIEW INFORMATION

REVIEW CRITERIA

2. REVIEW AND SELECTION PROCESS

3. ASSESSMENT OF RISK

VI. AWARD ADMINISTRATION INFORMATION

1. AWARD NOTICES

2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS

3. REPORTING

VII. AGENCY CONTACTS

VIII. OTHER INFORMATION

APPENDIX A: INSTRUCTIONS FOR COMPLETING APPLICATION FORMS IN EHBS

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I. Funding Opportunity Description

1. Purpose

This notice announces the opportunity to apply for funding under the National Health Center Training and Technical Assistance Partners (NTTAP) cooperative agreements, formerly known as National Training and Technical Assistance Cooperative Agreements (NCA). NTTAPs provide training and technical assistance (T/TA) to existing and potential Health Center Program award recipients and look-alikes (health centers) nationwide, both directly and through collaborations with other Health Resources and Services Administration (HRSA) funded T/TA partners.

HRSA will provide funding to organizations to identify health center T/TA needs and develop and deliver T/TA for health centers at a national level. NTTAPs will provide T/TA to support health centers that serve statutorily defined special populations and vulnerable populations,2 and to support all health centers through development area-specific T/TA. NTTAPs maximize the impacts of Health Center Program investments through T/TA that strategically positions health centers to increase access to high quality, comprehensive primary care services for underserved populations in an evolving health care landscape.

2. Background

NTTAPs are authorized by the Public Health Service Act, Title III, Section 330(l), (42 U.S.C. 254b(l)). For more than 25 years, HRSA has provided funding to partners that maximize the impact of the Health Center Program through the development and delivery of T/TA to health centers. The Health Center Program currently includes nearly 1,400 Health Center Program award recipients and approximately 50 look-alikes that operate approximately 12,000 service delivery sites in every state, the District of Columbia, Puerto Rico, the Virgin Islands, and the Pacific Basin. In 2018, funded health centers and look-alikes provided care to nearly 28.4 million patients.

NTTAPs provide national-level T/TA to support health centers to innovate and otherwise advance their operations and care delivery models to adapt to current and anticipated changes in the health care environment and in their local communities. T/TA provided by NTTAPs is an integral component of HRSA’s continuous learning health center system through which T/TA activities support health centers to systematically integrate internal data and experience with external evidence and shared knowledge to inform and improve the treatment and care of patients. NTTAPs identify health center T/TA needs and develop and coordinate T/TA resources with other HRSA-supported T/TA providers, including other NTTAPs, State and Regional Primary Care Associations (PCAs), and Health Center Controlled Networks (HCCNs).

2 Vulnerable populations have unique characteristics that affect culturally and linguistically competent health care access and utilization.

http://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section254b&num=0&edition=prelim http://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section254b&num=0&edition=prelim

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Program Overview

NTTAP funding is for a 3-year period of performance (July 1, 2020 to June 30, 2023) and will support the development, provision, coordination, and evaluation of national T/TA activities for health centers to maximize the impact of Health Center Program investments and thereby assist health centers to increase access to high quality, comprehensive primary care services for underserved populations in an evolving health care landscape.

NTTAPs will accomplish these goals and the related Objectives outlined in Appendix B:

NTTAP Types and Required Objectives through identifying and disseminating promising practices,3 developing and delivering trainings, and other T/TA activities.

To effectively meet the required objectives, at a national level, NTTAPs must:

• Monitor factors that affect health centers to inform T/TA activities and support HRSA awareness of issues that may affect health centers’ ability to maximize their impact and effectively address HRSA priorities.

• Support health centers to identify and implement evidence-based and promising practices to address HRSA priorities in ways that are most effective for the population or development area.

• Leverage health centers’ shared experience and data, along with evidence-based and promising practices knowledge, to improve the treatment and care of patients.

NTTAPs must engage and collaborate with other HRSA-supported T/TA partners (e.g., PCAs, HCCNs) to share data on T/TA needs, coordinate and align T/TA activities, and share T/TA resources and tools that will amplify impacts and reduce duplication of effort, as illustrated on the next page. To improve the outcomes of future T/TA activities, NTTAPs must collect, analyze, and disseminate T/TA evaluation results to health centers and HRSA T/TA partners, and contribute to a national health center T/TA needs assessment. T/TA provided by other HRSA T/TA partners includes:

• State and region-specific T/TA developed by PCAs to support increased access to comprehensive primary care services, accelerated value-based care delivery, a health center workforce that addresses current and emerging needs, enhanced emergency preparedness and response, and advanced health center clinical quality and performance.

• Tools and resources developed by HCCNs to increase participation in value-based care through enhancing the patient and provider experience, advancing interoperability, and using data to enhance value.

3 A promising practice is an activity, procedure, approach, or policy that leads to, or is likely to lead to, improved outcomes or increased efficiency for health centers.

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Training and Technical Assistance

For the purposes of this funding opportunity, training is defined as an educational tool designed to teach key concepts related to a particular topic, which is often delivered in small or large group settings (in-person seminars, distance webinars, workshops, or courses). Technical assistance is the process of providing targeted support to an organization to facilitate quality or performance improvement. Technical assistance can take many forms, which could include:

• Providing training such as webinars, networking meetings, and conferences to build knowledge, skills, or abilities;

• Conducting consultations on particular challenges to advance strategic priorities;

• Developing and sharing resources such as readiness tools, implementation manuals, and fact sheets; and

• Identifying, disseminating, and facilitating the implementation of evidence-based and promising practices.

NTTAP Requirements

For the purposes of this funding opportunity, applicants must propose to provide T/TA for only one NTTAP type in one category as summarized below. The number of projected awards for each NTTAP type is also indicated.

• Special Populations (9 awards) category:

o Migratory and Seasonal Agricultural Workers type (5 awards) o People Experiencing Homelessness type (2 awards) o Residents of Public Housing type (2 awards)

• Vulnerable Populations (4 awards) category:

o Lesbian, Gay, Bisexual and Transgender (LGBT) Populations type (1 award) o Asian Americans, Native Hawaiians and other Pacific Islanders type (1 award) o School-Aged Children type (1 award) o Older Adults type (1 award)

Health Centers

PCAs HCCNs

NTTAPs

HRSA and Federal Partners

Health Centers

PCAs HCCNs

NTTAPs

HRSA and Federal Partners

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• Development Areas (7 awards) category:

o Clinical Workforce Development type (1 award) o Health Workforce Recruitment and Retention type (1 award) o Capital Development and Growth type (1 award) o Health Information Technology and Data type (1 award) o Oral Health Care type (1 award) o Medical-Legal Partnerships type (1 award) o Intimate Partner Violence Prevention type (1 award)

• National T/TA Center category and type (1 award)

NTTAPs must monitor and share data on health center T/TA needs for the proposed NTTAP type. Specifically, all NTTAPs must contribute to the national health center T/TA needs assessment.

NTTAPs must ensure access to T/TA resources without regard to health center award or designation status, NTTAP membership status, or location.4 The ability for an NTTAP to charge for T/TA varies:

• NTTAPs cannot charge for T/TA supported solely with HRSA funds.

• For T/TA funded with a mix of HRSA and non-HRSA funds, charging participants to offset non-HRSA funded costs is permissible if the NTTAP can demonstrate that the charge is not a barrier to access.

NTTAPs should ensure that T/TA resources are accessible to the widest possible health center audience nationwide, which may include use of free webinars and on-demand recordings, following any live events. NTTAPs must also make T/TA available through the health center resource clearinghouse.5

In addition to providing T/TA to national health center audiences, NTTAPs must establish and conduct learning collaborative activities. NTTAP learning collaboratives must have:

• A minimum of 10 health center participants, with the majority being funded health centers.

• Documentation of commitment from participating health center leadership.

• At least 4 in-person and/or distance learning sessions in each budget period.

• A curriculum tailored to health center needs that contains planning periods, action periods, coaching, scaled implementation of models, and evaluation.

• Health center-level objectives that are clear, specific, data-driven, and measurable.

See Appendix A: Instructions for Completing Application Forms in EHBs and Appendix B: NTTAP Types and Required Objectives for additional details, including the required number of national and learning collaborative activities.

Failure to meet NTTAP Requirements may jeopardize NTTAP funding per Uniform Guidance 2 CFR part 200 as codified by HHS at 45 CFR part 75. HRSA will assess

5 To see the current version of the health center resource clearinghouse, visit https://www.healthcenterinfo.org/ http://www.ecfr.gov/cgi-bin/text-idx?tpl=/ecfrbrowse/Title02/2cfr200_main_02.tpl http://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=4d52364ec83fab994c665943dadf9cf7&ty=HTML&h=L&r=PART&n=pt45.1.75 https://www.healthcenterinfo.org/

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award recipients for compliance during the period of performance. When non-compliance is identified, HRSA will place a condition on the recipient’s award. If an organization fails to successfully resolve conditions, HRSA may withdraw support through cancellation of all or part of the cooperative agreement award (see penalties for noncompliance outlined by 45 CFR 75.371).

II. Award Information

1. Type of Application and Award

Type(s) of applications sought:

• Competing continuation – A current National Training and Technical Assistance Cooperative Agreement (NCA) award recipient whose period of performance ends June 30, 2020 that seeks to continue providing national health center T/TA.

• New – An organization not currently receiving NCA funding that seeks to provide national T/TA as one of the NTTAP types outlined in the Requirements section and listed in Appendix B: NTTAP Types and Required Objectives.

HRSA will provide NTTAP funding in the form of a cooperative agreement. A cooperative agreement is a financial assistance mechanism where substantial involvement is anticipated between HRSA and the recipient during performance of the contemplated project.

HRSA involvement in the cooperative agreement will include the following:

• Collaborate with award recipients to refine and approve the Project Work Plan according to HRSA priorities and changes in the health care landscape through such activities as identifying and prioritizing T/TA needs to be addressed using federal funds.

• Monitor and support implementation of the Project Work Plan through collaborative meetings, monthly calls, and progress report reviews.

• Review and support the development of key deliverables, including approval of the publication plan and specialized materials for general distribution prior to publication, distribution, and/or online posting.

• Attend and participate in NTTAP-related meetings, as appropriate.

• Coordinate with other Bureaus and Offices within HRSA to identify and support collaboration across and within programs.

• Identify opportunities to coordinate activities with other federally funded cooperative agreements.

• Conduct an NTTAP site visit once per period of performance to review and assess NTTAP Requirements compliance, review activities and key accomplishments, and identify promising practices that support the T/TA needs of health centers.

http://www.ecfr.gov/cgi-bin/text-idx?node=pt45.1.75&rgn=div5#se45.1.75_1371

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The cooperative agreement recipient’s responsibilities will include:

• Collaborate with HRSA on refining and implementing the Project Work Plan based on HRSA priorities and changes in the health care landscape, to include updates needed based on changes at the national level.

• Engage with HRSA to update Project Work Plans at least annually, or more frequently as needed (e.g., in response to site visit findings, to establish new Objectives and Activities once current Objectives are met).

• Provide a plan for publications to be created or disseminated with NTTAP funds and are intended for general audiences. The plan should include each publication’s purpose, target audience, title, publication code or type, summary description, expected impact and benefit, and projected publication date in accordance with HRSA’s Publication Protocol.

• Adhere to HRSA guidelines pertaining to required acknowledgement and disclaimer on all products produced with HRSA award funds, as noted on the Notice of Award.

• Participate in HRSA and related stakeholder meetings, as appropriate.

• Coordinate with national, federal, and state organizations to strengthen Project

Work Plan development and implementation.

• Ensure NTTAP Requirements compliance, including that activities supported in whole or in part with NTTAP funds are available to all existing and potential health centers, regardless of Health Center Program award or look-alike status, NTTAP organization membership, and/or location.

• Participate in a HRSA-led NTTAP site visit once during the 3-year period of performance. Information about the current NCA site visit process is available in the NCA Site Visit Guide.

2. Summary of Funding

HRSA expects approximately $22 million to be available annually to fund 21 recipients.

You may apply for up to the maximum annual award amount for the NTTAP type you selected. The actual amount available will not be determined until enactment of the final FY 2020 federal appropriation. This program notice is subject to the appropriation of funds, and is a contingency action taken to ensure that, should funds become available for this purpose, HRSA can process applications and award funds in a timely manner.

• Special and Vulnerable Populations NTTAPs: New applicants in this category may request up to $550,000 annually6; currently funded applicants will receive communication directly from HRSA with the maximum annual award amount, based on the FY 2019 award.

6 LGBT NTTAP type may request up to $625,000 annually due to required effort to support the Ending the HIV Epidemic: A Plan for America.

https://bphc.hrsa.gov/sites/default/files/bphc/datareporting/pdf/2019-nca-site-visit-guide.pdf https://www.hrsa.gov/ending-hiv-epidemic https://www.hrsa.gov/ending-hiv-epidemic

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• Development Areas NTTAPs: New and currently funded applicants in this category may request up to the following maximum annual funding amount:

o Clinical Workforce Development: $550,000 o Health Workforce Recruitment and Retention: $550,000 o Capital Development and Growth: $1,168,750 o Health Information Technology and Data: $693,000 o Oral Health Care: $550,000 o Medical-Legal Partnerships: $550,000 o Intimate Partner Violence Prevention: $550,000

• National T/TA Center: New and currently funded applicants in this category may request up to $6,625,000 annually.

The period of performance is July 1, 2020 through June 30, 2023 (3 years). Funding beyond the first year is subject to the availability of appropriated funds for NTTAPs in subsequent fiscal years, satisfactory recipient performance, and a decision that continued funding is in the best interest of the Federal Government. All HRSA awards are subject to the Uniform Administrative Requirements, Cost Principles, and Audit Requirements at 45 CFR part 75.

Note: Recipients may request supplemental funding at any point in their period of performance to address unique national health center T/TA needs that are connected to, but not duplicative of, the funded scope of work. HRSA may provide support such supplemental projects if funding is available and allocable, the request is reasonable and allowable, sufficient time remains in the budget period to approve the request, and the activities are aligned with HRSA priorities and nonduplicative of work performed by HRSA or other funding recipients.

III. Eligibility Information

1. Eligible Applicants

Eligible applicants include domestic public or private, non-profit, or for-profit entities that provide T/TA to community-based organizations that have or are seeking Health Center Program award recipient or look-alike designation status. Faith-based, tribes, and tribal organizations are eligible to apply for NTTAP funding. New organizations and organizations currently receiving funding as NCAs under Section 330(l) may submit applications.

2. Cost Sharing/Matching

Cost sharing or matching is not required for this cooperative agreement.

3. Other

Applications that do not include the Project Narrative will be considered non-responsive and will not be considered for funding under this notice.

http://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=4d52364ec83fab994c665943dadf9cf7&ty=HTML&h=L&r=PART&n=pt45.1.75

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Applications in which the applicant organization (as listed on the SF-424) does not propose to perform a substantive role in the project will be considered non-responsive and will not be considered for funding under this notice.

HRSA will consider any application that fails to satisfy the deadline requirements referenced in Section VI.4: Submission Dates and Times non-responsive and will not consider it for funding under this notice.

HRSA will only accept your first validated electronic submission, under the correct funding opportunity number (HRSA-20-022), in Grants.gov. Subsequent applications will be marked as duplicates and considered ineligible for review. If you wish to change information submitted in a Grants.gov application, you may do so in the HRSA Electronic Handbooks (HRSA EHBs) application phase.

Multiple applications from an organization are not allowable. HRSA will only review the first application you submit for Health Center Program T/TA funding in Fiscal Year 2020.

Subsequent applications across FY 2020 NOFOs focused on state, regional, and/or national Health Center Program T/TA will be considered non-responsive and will not be considered for funding.

You may apply for only one NTTAP type listed in the NTTAP Requirements section and Appendix B: NTTAP Types and Required Objectives.

Your annual funding request (as presented on the SF-424A and Budget Narrative) must not exceed the maximum allowable funding request for your proposed NTTAP type as outlined in the Summary of Funding section or communicated by HRSA. Applications that exceed this amount for Year 1 of the period of performance will be considered non-responsive and will not be considered for funding under this opportunity.

IV. Application and Submission Information

1. Address to Request Application Package

HRSA requires you to apply electronically through Grants.gov and the HRSA EHBs.

You must use a two-phase submission process associated with this NOFO and follow the directions provided at http://www.grants.gov/applicants/apply-for-grants.html and in the NTTAP EHBs user guide located on the NTTAP Technical Assistance webpage.

• Phase 1 – Grants.gov – Required information must be submitted and validated via Grants.gov with a due date of November 15, 2019 at 11:59 p.m. ET; and

• Phase 2 – HRSA EHBs –Supplemental information must be submitted via HRSA

EHBs with a due date of December 17, 2019 at 5 p.m. ET. Note that access to the HRSA EHBs application module will start October 18, 2019. You may submit in Grants.gov prior to this date, but you will not be able to begin Phase 2 of your application in HRSA EHBs until October 18.

http://www.grants.gov/applicants/apply-for-grants.html

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You must successfully submit the workspace application package associated with this NOFO in Grants.Gov (Phase 1) by the Grants.gov due date to submit the additional required forms and attachments in HRSA EHBs (Phase 2).

The NOFO is also known as “Instructions” on Grants.gov. You must provide your email address when reviewing or preparing the workspace application package, in order to receive notifications and/or republications of the NOFO on Grants.gov before its closing date. Responding to an earlier version of a modified notice may result in a less competitive or ineligible application. Please note you are ultimately responsible for reviewing the For Applicants page for all information relevant to desired opportunities.

2. Content and Form of Application Submission

Application Format Requirements Section 5 of HRSA’s SF-424 Two-Tier Application Guide provides instructions for the budget, budget narrative, staffing plan and personnel requirements, assurances, certifications, and abstract. You must submit the information outlined in the Application Guide in addition to the program-specific information below. You are responsible for reading and complying with the instructions included in HRSA’s SF-424 Two-Tier Application Guide except where instructed in the NOFO to do otherwise. You must submit the application in the English language and in the terms of U.S. dollars (45 CFR § 75.111(a)).

See Section 9.5 of the Application Guide for the Application Completeness Checklist.

Application Page Limit The total size of all uploaded files may not exceed the equivalent of 80 pages when printed by HRSA. The page limit includes the abstract, project and budget narratives, attachments, and letters of agreement and support. Standard OMB-approved forms do not count in the page limit. Indirect Cost Rate Agreement and proof of non-profit status (if applicable) do not count in the page limit. Take appropriate measures to ensure your application does not exceed the specified page limit.

Applications must be complete, within the specified page limit, validated by Grants.gov, and submitted under the correct funding opportunity number prior to the Grants.gov and HRSA EHBs deadlines to be considered under this notice.

Debarment, Suspension, Ineligibility, and Voluntary Exclusion Certification

1) You certify on behalf of the applicant organization, by submission of your proposal, that neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency.

2) Failure to make required disclosures can result in any of the remedies described in 45 CFR § 75.371, including suspension or debarment (See also 2 CFR parts 180 and 376, and 31 U.S.C. 3321).

3) Where you are unable to attest to the statements in this certification, an explanation shall be included in Attachment 8: Other Relevant Documents.

https://www.grants.gov/ https://www.grants.gov/web/grants/applicants.html http://www.hrsa.gov/grants/apply/applicationguide/sf424programspecificappguide.pdf

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See Section 5.1 viii of HRSA’s SF-424 Two-Tier Application Guide for additional information on all certifications.

Project-Specific Instructions In addition to application requirements and instructions in Sections 4 and 5 of HRSA’s SF-424 Two-Tier Application Guide (including the budget, budget narrative, staffing plan and personnel requirements, assurances, certifications, and abstract), include the following:

i. Project Abstract See Section 5.1.ix of HRSA’s SF-424 Two-Tier Application Guide.

ii. Project Narrative This section provides a comprehensive framework and description of all aspects of the proposed project. It should be succinct, self-explanatory, supported by and consistent with forms and attachments, and well organized so that reviewers can understand the proposed project.

Successful applications will contain the information below. Please use the following section headers for the narrative:

NEED -- Corresponds to Section V’s Review Criterion 1: Need

Information provided in this section must serve as the basis for and align with the Objectives specific to the proposed NTTAP type (see Appendix B: NTTAP Types and Required Objectives) and Activities described in the Project Work Plan.

Data must be specific to NTTAP type’s population of focus or developmental area and must reflect the needs of existing and potential health centers (e.g., organizations applying for the Oral Health Care NTTAP must outline oral health care needs of health centers).

1) Describe current conditions and recent or expected changes in the national health care environment relevant to your selected NTTAP type impacting existing and potential health centers and other safety net providers, including:

a. Natural disasters or emerging health issues and priorities (e.g., hurricanes, floods, the opioid crisis, the HIV epidemic).

b. Socio-cultural or environmental changes affecting statutorily defined special populations (migratory and seasonal agricultural workers, people experiencing homelessness, or residents of public housing) or vulnerable populations.

c. Shifting health information technology (health IT) opportunities, priorities, and resources.

d. Changing workforce needs and related recruitment and retention challenges.

e. New and emerging reimbursement mechanisms for primary health care (e.g., value-based; insurance coverage changes).

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2) Describe the data sources that inform your understanding of national T/TA needs of existing and potential health centers within your NTTAP type. Current data sources may include Health Center Program data (e.g., Uniform Data System (UDS) reports), annual T/TA satisfaction survey results, participant feedback from past T/TA trainings, and the national health center T/TA needs assessment.

You must include needs related to each Objective applicable to the NTTAP type you selected in Appendix B: NTTAP Types and Required Objectives.

3) Based on your current understanding of national T/TA needs of health centers as described above, discuss short- and long-term health center T/TA priorities specific to your proposed NTTAP type over the next 3 years. For the purpose of this NOFO, short-term refers to the first 12 months of funding, while long-term refers to the remaining two years of the 3-year period of performance.

RESPONSE -- Corresponds to Section V’s Review Criterion 2 Response

Note: The Project Work Plan should address ONLY activities that will be funded under the proposed cooperative agreement and will fulfill this NOFO’s Objectives.

1) Complete the structured Project Work Plan form electronically in EHBs, outlining activities to be completed in the first 12 months of the period of performance. The Project Work Plan must:

a. Demonstrate compliance with all NTTAPs Requirements.

b. Outline a complete plan to make progress toward achieving the NOFO’s

Objectives within the first 12 months.

c. Propose activities that are tailored to the needs of existing and potential health centers nationwide under one of the NTTAP types listed in NTTAPs Requirements and detailed in Appendix B: NTTAPs Types and Required Objectives.

d. Propose Objective Targets and activities based on current national health center T/TA needs that: (1) you describe in the application Project Narrative, and (2) are scaled to your capacity and level of funding requested.

e. Include at least two Activities for the national audience and one Activity for the learning collaborative audience for each Objective.

Instructions for completing the Project Work Plan are available in Appendix A:

Instructions for Completing Application Forms in EHBs. Required Goals and Objectives can be found in Appendix B: NTTAP Types and Required Objectives.

Appendix B also provides information on baseline data calculations for the Project Work Plan. A sample Project Work Plan is also provided on the NTTAP Technical Assistance webpage.

2) Describe how you will evolve and/or add new activities in Years 2 and 3 of the period of performance to achieve the stated Objectives by the end of the period of performance (June 30, 2023).

3) Describe strategies to overcome potential challenges in implementing the activities described in the Project Work Plan, approaches that will be used to

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resolve them, and how these approaches build on your organization’s current strengths, referencing the Key Factors identified in the Project Work Plan as appropriate.

4) Discuss current or anticipated federal and/or national initiatives that may affect Objective Target attainment or result in the need to adjust planned activities to better support health center achievement, take maximum advantage of new resources, avoid duplication of effort, and/or develop new or reprioritize existing partnerships.

5) Discuss how the proposed T/TA activities (e.g., training sessions, learning collaboratives, and webinars) will be made available and accessible (e.g., cost, location) to existing and potential health centers, regardless of health center award or designation status, NTTAP membership, or location.

COLLABORATION – Corresponds to Section V’s Review Criterion 3: Collaboration

1) Describe both current and proposed T/TA collaboration and coordination (formal and informal) with other HRSA supported T/TA providers and partners (e.g., other NTTAPs, PCAs, HCCNs, Area Health Education Centers, Public Health Training Centers), and other regional and national organizations (e.g., Regional Extension Centers, national clinical associations) to:

a. Accelerate achievement of the Objectives for your proposed NTTAP type.

b. Form linkages among a diverse membership to strengthen the nation’s primary health infrastructure.

c. Share, align, and coordinate T/TA resources to reduce duplication of effort among health center T/TA providers.

d. Make T/TA available through the health center resource clearinghouse.

e. Contribute to the national health center T/TA needs assessment.

Indicate if collaboration/coordination is current, planned for the purposes of supporting the proposed project, or both.

2) Provide documentation of current and proposed collaborations through letters of support, commitment, and/or investment that reference the specific collaboration and/or coordinated activities in support of the proposed project as Attachment 5:

Letters of Agreement. At a minimum, include a dated letter of support from the primary formal collaborators noted in the response to Item 1 above. If you did not obtain one or more letters of support, include documentation of your efforts/requests to obtain the letters and any additional explanatory information.

3) Organizations applying as Special Populations NTTAPs ONLY: Describe how your T/TA plans and activities will be coordinated and aligned with other NTTAPs focusing on your proposed special population (i.e., Migratory and Seasonal Agricultural Workers, People Experiencing Homelessness, or Residents of Public Housing).

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EVALUATIVE MEASURES -- Corresponds to Section V’s Review Criterion 4:

Evaluative Measures

1) Within the Project Work Plan (see Appendix A: Instructions for Completing

Application Forms in EHBs for field descriptions):

a. Set Objective Targets that are realistic, achievable, and advance achievement of Objectives by the end of the 3-year period of performance.

b. Write meaningful Objective Impact Narratives that link activities to achievement of the Objective Targets by the end of the 3-year period of performance.

c. Project appropriately scaled and achievable targets for required process measures.

d. Provide clear Expected Outcomes for each Activity that will enable the tracking of progress over time.

2) Describe a plan for evaluation of the T/TA activities that will:

a. Solicit and incorporate regular input from existing and potential health centers, as well as from other T/TA providers (e.g., PCAs, HCCNs, other NTTAPs), not duplicating the national health center T/TA needs assessment.

b. Include the use of valid, reliable, and consistent quantitative and qualitative data sources from existing and potential health centers, collaborative partners, and other national stakeholders to assess the quality, reach, and perceived usefulness of T/TA activities.

c. Ensure utilization of consistent data sources to frequently monitor and measure impact, including progress towards Objectives and Expected Outcomes.

d. Ensure the use of evaluation results to improve T/TA performance as part of continuous quality improvement.

3) Describe your plan for dissemination of evaluation results to health centers, other

NTTAPs, PCAs, HCCNs, and other relevant T/TA providers, including the health center resource clearinghouse and national health center T/TA needs assessment.

RESOURCES AND CAPABILITIES -- Corresponds to Section V’s Review Criterion 5:

Resources and Capabilities

1) Demonstrate your capability to successfully provide national T/TA to existing and potential health centers by documenting your experience and expertise in:

a. Coordinating and providing health center T/TA activities of similar scope

(focusing on both national and learning collaborative audiences), including a description of past performance, accomplishments, and lessons learned.

b. Responding rapidly to changes taking place in the health care environment related to the NTTAP type you selected.

2) Current NCA award recipients ONLY: Document successes and capabilities in Attachment 7: Summary Progress Report for Current NCAs, to include a

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summary of the accomplishments achieved since submission of the last Non- Competing Continuation (NCC) Progress Report.

3) Describe how the organizational structure, including any contracts or agreements, (consistent with Attachment 1: Organizational Chart and Attachment 6: Summary of Contracts and Agreements) is appropriate for the operational and oversight needs of the project.7

a. Describe how the proposed staffing plan Attachment 2: Staffing Plan is appropriate for the projected number and variety of T/TA activities (national and learning collaborative) to be provided during the period of performance.

b. Describe a plan for recruiting and retaining staff to achieve or maintain the proposed staffing plan.

c. Describe your organization’s financial accounting and internal control systems and how they, as well as related policies and procedures, will reflect Generally Accepted Accounting Principles (GAAP).8

4) Describe how your organization’s management team (Chief Executive Officer

(CEO), Clinical Director (CD) or Chief Medical Officer (CMO), Chief Financial Officer (CFO), Chief Information Officer (CIO), Chief Operation Officer (COO) and Project Director (PD)) is appropriate for the operational and oversight needs, scope, and complexity of the proposed project, including:

a. Define roles (consistent with Attachment 3: Job Descriptions for Key Personnel), in particular the Project Director or equivalent position such as CEO who is responsible for day-to-day management of NTTAP activities.

b. Skills and experience for the defined roles consistent with Attachment 4:

Biographical Sketches of Key Personnel.

c. If applicable, recent changes in key management staff or significant changes in roles and responsibilities.

5) Describe how you will ensure that proposed T/TA delivery will be initiated within

60 days of award by documenting that appropriate staff will be in place. Provide a timeline for hiring, onboarding, and staff development, as needed.

SUPPORT REQUESTED – Corresponds to Section V’s Review Criterion 6: Support Requested

1) Provide a consistent and detailed budget presentation through the submission of the following: SF-424A and Budget Narrative. Refer to Section IV.2.iv Budget Narrative for budget presentation instructions.

2) Describe how your budget is appropriate and reasonable for the proposed project, including alignment with the Project Work Plan and information provided in the attachments (e.g., Attachment 2: Staffing Plan, Attachment 6: Summary of Contracts and Agreements).

7 NTTAP award recipients and contractors are subject to the HHS grant requirements set forth in Uniform Guidance 2 CFR part 200 as codified by HHS at 45 CFR part 75 as applicable.

8 GAAP are used as defined in HHS Grants Policies and Regulations 45 CFR Part 75 http://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=4d52364ec83fab994c665943dadf9cf7&ty=HTML&h=L&r=PART&n=pt45.1.75 http://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=4d52364ec83fab994c665943dadf9cf7&ty=HTML&h=L&r=PART&n=pt45.1.75 https://www.hhs.gov/grants/grants/grants-policies-regulations/index.html

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NARRATIVE GUIDANCE

To ensure that you fully address the review criteria, this table provides a crosswalk between the narrative language and where each section falls within the review criteria.

You should use both the Project Narrative and Review Criteria sections as you develop your application. Reviewers will use both when scoring your application.

Narrative Section Review Criteria Need (1) Need Response (2) Response, including the Project Work

Plan Collaboration (3) Collaboration Evaluative Measures (4) Evaluative Measures, including the

Project Work Plan Resources and Capabilities (5) Resources and Capabilities Support Requested (6) Support Requested

iii. Budget

See Section 5.1.iv of HRSA’s SF-424 Two-Tier Application Guide. Follow the instructions included in the Application Guide and the additional budget instructions provided below. A budget that follows the Application Guide will ensure that, if HRSA selects the application for funding, you will have a well-organized plan, and by carefully following the approved plan, can avoid audit issues during the implementation phase.

Reminder: The Total Project Costs are the total allowable costs (inclusive of direct and indirect costs) you incur to carry out a HRSA-supported project or activity.

The Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019 (P.L. 115-245), Division B, § 202 states, “None of the funds appropriated in this title shall be used to pay the salary of an individual, through a grant or other extramural mechanism, at a rate in excess of Executive Level II”. See Section 5.1.iv Budget – Salary Limitation of HRSA’s SF-424 Two-Tier Application Guide for additional information. Note that these or other salary limitations may apply in the following FY, as required by law.

iv. Budget Narrative (submitted in EHBs) See Section 5.1.v. of HRSA’s SF-424 Two-Tier Application Guide.

Provide a detailed Budget Narrative and table of personnel to be paid with federal funds for each 12-month budget period of the 3-year period of performance (for example, the first budget period starts July 1, 2020 and ends June 30, 2021). For subsequent budget years, the Budget Narrative should highlight the changes from Year 1 or clearly indicate that there are no substantive changes during the period of performance. You are required to budget funding for at least 1 HRSA-sponsored NTTAP-related conference in year 1. For a sample Budget Narrative, see the NTTAP Technical Assistance webpage. Do not include non-federal funding in the Budget Narrative.

http://www.hrsa.gov/grants/apply/applicationguide/sf424programspecificappguide.pdf https://www.hrsa.gov/sites/default/files/hrsa/grants/apply/applicationguide/sf-424-app-guide-2-tier.pdf https://www.hrsa.gov/sites/default/files/hrsa/grants/apply/applicationguide/sf-424-app-guide-2-tier.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424programspecificappguide.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424programspecificappguide.pdf

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Be aware that Excel or other spreadsheet documents with multiple pages (sheets) may not print out in their entirety. Reviewers will only see information that is set in the “Print Area” of the document.

v. Program-Specific Forms (Submit in HRSA EHBs)

Program Specific Forms include Form 1A and the Project Work Plan. Refer to Appendix A: Instructions for Completing Application Forms in EHBs for instructions on how to complete and submit these forms in EHBs.

vi. Attachments

Provide the following items in the order specified below. Unless otherwise noted, attachments count toward the application page limit. All attachments will support the objective review. Indirect cost rate agreements will not count toward the page limit. You must clearly label each attachment.

Attachment 1: Organizational Chart

Upload a one-page document that depicts the organizational structure, including key personnel, staffing, and any sub-recipients or affiliated organizations of the proposed NTTAP project.

Attachment 2: Staffing Plan Upload a table that identifies the total personnel to be supported under the NTTAPs cooperative agreement. The staffing plan is a presentation and justification of all staff required to execute the project, education, experience qualifications, and rationale for the amount of time being requested for each position. Refer to the NTTAP Technical Assistance webpage for a Sample Staffing Plan.

Attachment 3: Job Descriptions for Key Personnel

Upload current job descriptions for key management staff: CEO, CD/CMO, CFO, CIO, COO, and PD. Indicate on the position descriptions if key management positions are combined and/or part time. Limit each job description to one page and include, at a minimum, the position title; description of duties and responsibilities; position qualifications; supervisory relationships; skills, knowledge, and experience requirements; travel requirements; salary range; and work hours. Indicate if any of the positions are currently vacant.

Attachment 4: Biographical Sketches of Key Personnel

Upload biographical sketches for individuals occupying the positions described in the Job Descriptions for Key Personnel (Attachment 3). Biographical sketches should not exceed two pages each. When applicable, biographical sketches must include training, language fluency, and experience working with the cultural and linguistically diverse populations to be served.

Attachment 5: Letters of Agreement Provide evidence of endorsements and other proposed and/or current collaborations that reference specific partnerships and/or coordinated activities in

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support of the proposed NTTAP project. At a minimum, applicants must include a current letter of support from the primary formal collaborators noted in the Collaboration section of the Project Narrative. Letters of support, commitment, and/or investment must be dated and addressed to the organization’s board, CEO, or other appropriate key management staff member, not HRSA staff.

Letters of support that are not submitted with the application will not be considered by the objective review committee.

Attachment 6: Summary of Contracts and Agreements (if applicable) Upload a brief summary describing all current or proposed contracts and agreements. Include the following for each contract or agreement:

• Name of organization.

• Type of contract or agreement (e.g., contract, Memorandum of Understanding or Agreement).

• Brief description of the purpose and scope of the agreement and how/where services are or will be provided.

• Timeframe for each contract or agreement (e.g., ongoing contractual relationship, specific duration).

You must exercise appropriate oversight and authority over all contracts, and procurement contracts must comply with 45 CFR part 75 or 45 CFR part 92.

Attachment 7: Summary Progress Report for Current NCAs (required for current NCA award recipients only)

Provide a summary of the accomplishments achieved since submission of your last NCC progress report. Include T/TA progress and how this progress has, or is expected to, impact achievement of the goal targets outlined in your most recent Project Work Plan.

Attachment 8: Other Relevant Documents (if applicable)

If indirect costs are requested, upload your current Indirect Cost Rate agreement.

If desired, include other relevant documents to support the proposed project (e.g., charts, organizational brochures). Maximum of two uploads are permitted.

3. Dun and Bradstreet Data Universal Numbering System…